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Biomedical subjects

Paolo Cappabianca

Publications and source records attributed to Paolo Cappabianca.

44 records · Page 3Linked to original sources
PubMed2002

Lumbar diskectomy with preservation of the ligamentum flavum.

RE: Aydin Y, Ziyal IM, Duman H, Türkmen CS, Başak M, Sahin Y. Clinical and radiological results of lumbar microdiskectomy technique with preserving of ligamentum flavum comparing to the standard microdiskectomy technique. Surg Neurol 2002;57:5-14. The authors compare results of surgery in 400 patients who underwent microdiskectomy with preservation of the ligamentum flavum (Group 1) with those of 200 patients operated on by standard microdiskectomy (Group 2). Mean follow-up was 36.8 months in Group 1 and 32.4 months in Group 2; outcome was evaluated clinically and by patient questionnaire. Early clinical outcome was satisfactory in 96.75% of patients in Group 1 and in 81.5% in Group 2; reoperation rates were 4.5% and 9%, respectively. Overall success rate based on the patient questionnaire was 91% in Group 1 and 76% in Group 2. The authors conclude that the ligamentum flavum preservation technique is helpful in achieving good long-term results.

Diskectomy↗
PubMed2002

Endoscopic examination of the cerebellar pontine angle.

This anatomic study describes how to optimize the use of the endoscope in the cerebellar pontine angle (CPA) through a retrosigmoid approach. Unlike the microscope, that only permits visualization of structures directly ahead, the endoscope can see 'around the corner', also showing the structures down narrow. Nevertheless, to use the endoscope it is necessary to insert it into the CPA that is full of neurovascular structures which limit its movements. Thus, to avoid damages it is important to inspect this region accurately, by means of preferential trajectories to insert the endoscope. A retrosigmoid approach was performed in cadaver heads, and the CPA region was inspected employing 0 degrees, 45 degrees rigid endoscopes (4 mm in diameter). The neurovascular structures of the CPA have been visualized using three trajectories. The limits of view offered by each trajectory as well as the neurovascular structures together with the obstacles encountered on each route have been described. The systematic adoption of three different endoscope trajectories at the CPA level permits to view from different angulation the same structure as well as its relationships with the surrounding nerves and vessels. Considerable experience on cadavers should have already been obtained with the endoscope prior to any application in the operating room.

Anthropometry↗
PubMed2002

Endoscopic transsphenoidal approach: adaptability of the procedure to different sellar lesions.

OBJECTIVE: To demonstrate the flexibility of the endoscopic transsphenoidal approach, with respect to nasal and paranasal anatomic features and the extension of different sellar lesions, for customization of the procedure for specific conditions. METHODS: In 16 of 170 consecutive endoscopic transsphenoidal operations, some modifications of the standard approach were adopted to optimize surgical removal of different lesions. These modifications consisted of a hemisphenoidotomy, a partial ethmoidectomy, extended sellar floor opening toward the planum sphenoidale or the clivus, enlarged opening of the sphenoid ostium area with ipsilateral removal of the superior turbinate, and a bilateral approach. RESULTS: The endoscopic endonasal procedure is easily adaptable to different specific conditions, with slight changes in the standard approach (more or less invasive). Therefore, this surgical procedure is satisfactory for different lesion locations and for the nasal and paranasal sinus anatomic features of individual patients. CONCLUSION: The endoscopic surgical route should be tailored to different sellar lesions, and some modifications of the procedure are recommended in selected cases.

Adenoma↗
PubMed2002

Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas.

OBJECT: To assess postoperative complications related to the surgical procedure, a retrospective analysis was conducted in a series of 146 consecutively treated patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of pituitary adenomas between January 1997 and July 2001. METHODS: Complications were divided into groups (nasofacial, sphenoid sinus, sella turcica, supra or parasellar, and endocrine complications) according to the anatomical structures and the systems involved. Overall, a decreased incidence of complications has been observed, compared with large historical series of the traditional microsurgical transsphenoidal approach, likely because of the overview inside the anatomy facilitated by the endoscope, and the decreased surgical trauma. CONCLUSIONS: Transsphenoidal surgery, either microscopic or endoscopic, is a safe procedure in experienced hands, but serious complications still occur and must be reduced as much as possible. Additional improvement can be expected with greater experience and new technical developments. A coordinated team effort with other dedicated colleagues from different specialties is advised.

Adenoma↗
PubMed2002

Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases.

OBJECTIVE: To describe techniques and materials used in sellar repair after an endoscopic endonasal transsphenoidal approach. METHODS: Different techniques of sellar closure and indications for each specific condition are reviewed in a series of 170 consecutive patients. RESULTS: Only 47 (27.6%) of 170 patients were considered candidates for sellar reconstruction after the endoscopic operation, mainly because of intraoperative cerebrospinal fluid leaks (14.1%). The overall rate of postoperative cerebrospinal fluid leakage was 2.3%, which was cured by means of an early reoperation in three cases and with lumbar drainage in the fourth case. CONCLUSION: Reconstruction of the sella was considered necessary in only one-third of the patients who underwent operations via an endoscopic transsphenoidal procedure. Some minor expedients can be useful for the reconstruction, and the ideal material for the repair should be chosen.

Adenoma↗